(1.) Dr. Wall, who would you consider a good candidate for girth enhancement?
A good candidate is anyone wanting to inject confidence into this area of their lives. They should be above 18, be fit and well medically and have a goal to increase flaccid and erect girth, and increase flaccid length. Men experiencing retraction of the penis during sport/cold weather or just in general, notice a significant improvement in flaccid length after this procedure. They typically go from being a 'grower to a shower'. Men who suffer from premature ejaculation are excellent candidates for glans dermal fillers. This decreases sensation in the head of the penis resulting in significantly longer lasting performance without the need for medications.
(2.) Dr. Wall, do you use a needle for injections or a blunt-tip cannula? Do you see any advantages with your preference over the other?
I prefer the use of a blunt tip cannula. I perform a dorsal nerve block to the base of the penis first to numb it along its whole length. I then use a slightly larger size cannula then most practitioners to avoid the risk of damage to veins and arteries. Smaller gauge cannulas can more easily penetrate the deep fascia, which can lead to scarring of the fascia that can result in permanent deformities to the shaft, along with damage to underlying erectile tissue/nerves and vessels. A needle is used to inject the head of the penis. It is performed in a similar way to lip fillers. 3-5ml into the glans is the usual amount for best results. Rarely, you may need to use a needle in some circumstances such as previous use of collagen stimulating injections such as Ellanse. The collagen stimulating process causes a thickening of the internal architecture between the fascial layers making it hard to pass a cannula. This situation is uncommon.
(3.) Dr. Wall, do you use any healing or growth factors like PRP (Platelet Rich Plasma) to aid in the overall recovery and/or results of a procedure? We use Emcyte PRP for erection enhancement P-Shots. The feedback I have about this is really remarkable. I hear many of my patients say it takes them back to when they were in their early 20s in regards to strength and longevity of erection. The caveat I will put on PRP results are that not all PRP is created equal. When investigating which clinic to attend for PRP, I suggest looking at the amount of platelets concentrated per ml. Most inferior PRP concentrating systems have 400-600 thousand platelets per ml. Emcyte PRP has 1.2-1.5 million platelets per ml. To explain how it works, Platelet Rich Plasma treatments harness the natural healing and regenerative capabilities of platelets. In normal physiology, these cells are the first to arrive at the scene of an injury. They help in the clotting process, but play a special role in healing, releasing growth and healing factors. The more platelets, the more growth and healing factors. That is why it is important to choose a device with superior concentrating abilities. Most of my patients choose to have both PRP and Filler phalloplasty as a complete downstairs rejuvenation package.